ABSTRACT
Objective:To analyze the pathological types, tissue sources and clinical features of malignant pleural effusion.Methods:Cell masses were collected from 105 cases of malignant pleural effusion diagnosed by immunohistochemical examination after liquid-based cytology between May 2017 and October 2019 in Qidong People's Hospital, China. The pathological, morphological, immunohistochemical and clinical characteristics of the cell masses were analyzed.Results:Immunohistochemistry results showed that pleural effusion malignant cells were from lung adenocarcinoma tissue in 94 (89.52%) cases because they were positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen, from small cell lung cancer tissue in one (0.95%) case because they were positive for neural cell adhesion molecule 1 and synaptophysin,from lung squamous cell carcinoma tissue in 2 (1.90%) cases because they were positive for cytokeratin 5/6 and P40, from ovarian adenocarcinoma tissue in 1 (0.95%) case because they were positive for CA125, from breast adenocarcinoma tissue in 4 (3.81%) cases because they were positive for estrogen receptor, progesterone receptor and gross cystic disease fluid protein 15, from the gastrointestinal tract adenocarcinoma tissue in 2 (1.90%) case because they were positive for caudal-type homeobox 2, and from the pancreatic adenocarcinoma tissue in 1 (0.95%) case because they were positive for cancer antigen 19-9 (CA199).Conclusion:Lung adenocarcinoma is the most common cause of malignant pleural effusion. Lung adenocarcinoma cells are positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen. The combined use of the three markers can help the diagnosis of lung adenocarcinoma. In addition, lung adenocarcinoma should be differentiated from other types of lung cancer and the tumors from other regions.
ABSTRACT
Objective@#To identify underlying reasons for discrepant cases of positive cytology but negative histology.@*Methods@#Cases with positive cytology and negative histology from 2008 to 2016 were retrieved from Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University. Low grade squamous intraepithelial lesion or higher grade lesions were considered as positive cytology test in the study. Consecutive follow-up biopsies and as well as sites of biopsy were documented for analysis.@*Results@#Overall positive rate of biopsy followed positive cytology was 74.3%(8 990/12 097). Of the negative biopsies, 675 cases were followed-up with multiple biopsy. Two-hundred and eighty-seven cases (42.5%, 287/675) were confirmed to have lesions. Comparing with those with initial positive biopsiews, patients of the latter group were significantly older and had other specimen types including vaginal biopsy, cone biopsy and hysterectomy. The final histological diagnoses were well correlated with cytological results (Kappa=0.505, P<0.01).@*Conclusions@#Qualified cervical cytology is complimentary to histological diagnosis. Clinicians should not ignore the positive cytological result prior to a normal histological diagnosis. In contradictory cases, repeated colposcopy and biopsy at extended anatomic sites may reveal additional lesions.
ABSTRACT
Objective To explore the feasibility of EGFR, KRAS and PIK3CA mutation analysis on rapid on-site evaluation (ROSE)cytological slides in patients with non-small cell lung cancer and its clinical value. Methods Seventy-five cases of ROSE cytological slides and paired histological specimens were collected in Tianjin Medical University General Hospital. xTAG70plex liquidchip technology was used to analyze the gene mutations of the samples.Results The KRAS mutation was found in histological specimen but not in ROSE cytological slides in one case. The mutation results were the same in histological specimen and ROSE cytological slides in other cases.The consistent rates of the EGFR mutation and KRAS mutation were 100% and 98.7%,respectively. Conclusion Our study demonstrates that xTAG70plex liquidchip technology can be used for the mutation analysis of EGFR,KRAS and PIK3CA genes in non-small cell lung cancer on ROSE cytological slides.
ABSTRACT
Objective To estimate the clinical value of thinprep cytologic test (TCT) in screening cervical lesion. Methods 4234 TCT samples were interpreted according to the Besthesda System (TBS), 272positive cases (ASC-US or above) were taken colposcopic examination and biopsy. Results The coincidence of the results between TCT and biopsy in low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), squamous cell carcinoma (SCC), adenocarcinoma (AC) were 85.71%(12/14), 100 % (20/20), 75 % (3/4) and 100 % (2/2), respectively. The positive rates of over ASC-H by TCT and of over CIN Ⅰ by biopsy were 23.16 % (63/272) and 24.26 % (66/272), respectively. There is no difference between two positive rates (x2 = 0.868, P = 0.581). Conclusion TCT and histopathological diagnosis had a high coincidence, a combination of both can greatly enhance HSIL and cervical cancer and reduce the incidence of missed diagnosis. TCT would be a rapid and convenient method for screening cervical cancer.
ABSTRACT
Objective To explore the diagnosis value of morphology changes of pleomorphic megakaryocytes in the bone marrow (BM) smears and BM sections in chronic MPD(CML-CP, ET,PV and PMF). Methods BM aspiration was taken in 182 patients of MPD aspiration and biopsy examination was performed synchronously to obtain the BM smears and BM sections samples. The BM smears were subjected to Wright/Giemsa stain and immunohistochemistry stain, while the BM sections were subjected to Haematoxylin-Giemsa-Fuchsin stain. The morphology of pleomorphic megakaryocytes was classified into five groups, which were Ⅰ type ( inclusion type), Ⅱtype ( hypolobulated muclei type), Ⅲ type ( giant hyperlobulated nuclei type), IV type (micro pyknotic type), and V type(extrusion type). The size of megakaryocytes clusters was recorded as no clusters(0) , predominantly small clusters of fewer than 6 cells (1) or predominantly large clusters of at least 6 cells (2) . The detection rates of various types of pleomorphic megakaryocytes and megakaryocytes clusters were both analyzed in the BM smears and BM sections. Results In CML-CP group, the detection rates were (3. 73±3. 84)% , (14.19 ±7. 62)% ,(5.99 ±4.67)%, (34. 37 ±10.79)%, (9.45 ±6. 87)%, (32. 28 ±7. 67)% and 3.13 ±2. 30)% ,(12.61 ± 9.28)%,(4.94±4.27)%,(35.26±9.63)%,(9.47 ±5.89)%,(34.58 ±6.81)% for I tⅠype,Ⅱ type,Ⅲ type, Ⅳtype and Ⅴ type pleomorphic megakaryocyte in BM smears and BM sections. There were no significantly differences between the BM smears and BM sections(t value were 0.524,0.510,0.645, 0.239,0.011,0. 869,all P>0.05). In ET group, the detection rate of I type [ (6.17 ±2. 89)% ] in BM smears was significantly higher than that in BM sections [ 2.42 ± 1. 28) % ] (t = 7. 183, P < 0. 01) , while the detection rate of V type [ (6. 28 ± 3. 34) % ] in BM smears was significantly lower than that in BM sections [ (10. 18± 4.03) % ] (t = 3.940, P < 0.01). Besides these, the detection rates of other types were not significantly different between the BM smears and BM sections(t value were 0.079,0. 122,1.643, 1. 638,all P>0. 05). In PV group, the detection rate of V type in BM smears [ (6. 55 ±4. 11)% ] was significantly lower than that in BM sections [ (10. 30±3. 34) % ] (t = 2. 351, P < 0.05 ). However, the detection rates of the other types were not significantly different between the BM smears and BM sections (t value were 1. 635,0. 301,0. 132,0. 704,0. 681 ,all P' >0. 05). In PMF group, the detection rate of IV type in BM smears [(13.05 ±5.24)%] was significantly lower than that in BM sections [(29.14± 8. 72) % ] (t = 5. 245, P < 0. 01). And the detection rate of normal type in BM smears [ ( 33. 58 ± 14.39)% ] was significantly higher than that in BM sections [(23. 01±7.96)%] (t =2. 132,P<0. 05). Besides these, the detection rates of the other types were not significantly different between BM smears and BM sections( t value were 0. 787,0.646,2.062,0. 869, P > 0. 05 ) . In CML-CP and PV groups, the detection rates of size of clusters were not significantly different between the BM smears and BM sections (x~2 = 2. 772, P > 0. 05 ). In ET group, the detection rate of small clusters (1) in BM smears was obviously higher than that in BM sections, however, the detection rate of larger clusters (2) in BM smears was obviously lower than that in BM sections (x~2 = 13. 748, P < 0.01). In PMF group, the detection rate of no clusters(0) in BM smears was obviously higher than that in BM sections, however, the detection rate of large clusters(2) in BM smears was obviously lowers than that in BM sections (x~2 =18.741 ,P<0. 01). Conclusions Both BM smears and BM sections can be applied to observe pleomorphic megakaryocytes. The morphology changes of pleomorphic megakaryocytes have certain reference values for identification of MPD subtypes and differential diagnosis.
ABSTRACT
Objective To explore the clinical significance of the union between marrow smear and marrow biopsy in the myelodysplastic syndrome(MDS) diagnosis. Methods Bone marrow aspirate and smear were initially abtained, then bone tissues encircled drill and section at the same point which is called as. easy one-step technology to 86 MDS patients were analysed. Results In 86 cases of MDS patients, there were 30 cases of hyperplasia extreme degree of reduction by 34.88 %, 56 eases of active, obvious and extremely active active (65.12 %), 43 cases for red RCMD (50.00 %), 32 cases for the granulocyte dysplasia (37.21%), 22 cases for megakaryocyte RCMD (25.58 %) in bone marrow aspiration smears; compared with 15 cases of hyperplasia extreme degree of reduction and the reduction (17.44 %), 71 eases of active, obviously active and extremely active (82.56 %); 16 cases for red RCMD (18.61%), 52 cases for the granulocyte dysplasia (60.47 %), 56 cases for megakaryocyte RCMD (65.12 %) in bone marrow biopsy sections. 66 cases in 86 cases of bone marrow biopsy and bone marrow smear of WHO classification were in line with the rate of 76.74 %.Conclusion The biopsy slide and the puncture smear synchronization observation is more advantageous than the conventional puncture smear morphology observation and combining two method may increase the accuracy in the MDS diagnosis.
ABSTRACT
Objective Frozen section(FS)and touch imprint cytology(TIC)were common methods for intraoperative evaluation of sentinel lymph node(SLN)biopsy in breast cancer,with low sensitivity when used separately.The purpose of this study was to evaluate the value of combination of these two techniques.Methotis This study included 400 sentinel nodes from 150 patients with breast cancer.352 sentinel nodes were bisected along the long axis.Each sectioned surface of SLN was imprinted onto the surface of a slide and was analyzed by cytologist;meanwhile SLN were analyzed with intraoperative FS.The other 48 SLN were only analyzed with intraoperative PS due to their small size.Results of intraoperative P3 and TIC were compared with final pathology.Results Eighty-nine positive SLN from 55 patients were identified by final pathology.The specificity of FS and TIC were both 100%.According to the number of SLN.the sensitivity of TIC and FS was 71.9%(64/89)and 83.1%(74/89),respectively(P＞0.05).The sensitivity of TIC compared with FS was 96.6%(86/89),significantly higher than that of TIC and FS separately(both P＜0.001).According to the number of patients,the sensitivities of TIC and FS were 80.0%(44/55)and 81.8%(45/55),respectively(P＞0.05).The sensitivity of TIC compared with FS was 94.5%(52/55).significantly higher than that of TIC and FS separately (both P＜0.001).Conclusion Combination of FS and TIC for the intraoperative diagnosis of SLN biopsy in breast cancer was reliable,with hish sensitivity and specificity,and could avoid the second axillary operation efficiently.